The massive scale of urbanization in South Asia is expected to create a surge in demand for solid waste services. An enormous opportunity exists to improve upon the “business-as-usual” approach of uncollected waste and open dumping witnessed throughout the region and to convert this waste into value-added resources, such as alternative fuels and agricultural fertilizers. As approximately 70% of the region’s municipal waste stream is currently organic (biodegradable) waste, methods such as composting, anaerobic digestion, and conversion to refuse-derived fuels offer a more sustainable course of action. This report aims to align South Asian cities with ADB‘s Strategy 2020 for environmentally sustainable growth and livable cities. It provides a useful management resource, identifying key issues and pointing policy makers, city managers, and practitioners to improved waste treatment technologies.